| That is a very good question. | | | | functional department such as laboratory testing, |
| I am not sure any one thing will 'save' healthcare. We | | | | radiology, and medical clinics. Patients travel from one |
| are in a time of 'white water' change in medicine. | | | | site, queue up and after being 'processed' in that |
| New discoveries and new treatments race to the | | | | department are sent to another department. Thus |
| bedside. There will instead be a constellation of things | | | | for a 2 minute blood test, 5 minute radiograph of the |
| that will improve our healthcare systems. The future | | | | chest and a 10 minute doctor's visit the patient may |
| of medicine is in the provision of personalized | | | | have spent all day go to and from these functional |
| medicine. This is typically discussed in relationship to | | | | villages. The clinics of the near future should be |
| the Humane Genome project and molecular medicine. | | | | organized into a "cellular" model which will allow all the |
| However, it is much more than that. | | | | services to take place within the clinic, rather than |
| Personalized medicine is providing the 'right care at | | | | this functional "village' model where patients travel |
| the right time'. Often in the management of chronic | | | | between functions such as lab, clinic and radiology. In |
| conditions care is arranged 'just in case'. | | | | the future those functions will be provided at the |
| Appointments are scheduled into the future 'just in | | | | point of care. Personalized medicine will become the |
| case' you need to be seen. This is a symptom of the | | | | 'right care, at the right time, in the right place'. |
| tradition of medicine that dictated care to the patient | | | | Lean Thinking in healthcare is not just about how to |
| rather than negotiated care with the patient. | | | | reduce the administrative burden or waiting times of |
| Personalized medicine will change our healthcare | | | | the patient. It is also important to consider the costs |
| processes dramatically in the future. Personalized | | | | that patients undergo in accessing services. Even if |
| medicine will require our systems to provide | | | | the patient does not pay personally for their care, |
| 'customized' solutions for patients. Medications are | | | | there is a cost. Much of that cost is hidden and does |
| chosen based on a genetic analysis of the patient. | | | | not occur in the clinic or hospital. It occurs as a result |
| Other patient needs will also become important to | | | | of the time and effort to get to the hospital or clinic. |
| meet. After hours clinics already seek to personalize | | | | An easy illustration is trouble a patient undergoes in |
| care. Patients will be able to request or pull services | | | | traveling to the office, finding a parking place, then |
| without long queues. Some systems already allow | | | | walking to the office and then repeating at the other |
| patients to go online and select their appointment | | | | 'villages'. The travel costs represent a barrier to many |
| time without ever speaking to a clerk. The services | | | | of our patients. Technology solutions will allow an |
| they pull will be those that have value for them. Lean | | | | amendment to the mantra of 'right care at the right |
| will provide the basis for understanding the value | | | | time' by providing care at a distance. Telemedicine |
| added activities that will compose personalized | | | | and telehealth combined with point of care testing will |
| medicine. | | | | be a norm. This will move medicine away from the |
| Lean Thinking is directed at reducing waste. This will | | | | bricks and mortar of the clinic and hospital. The |
| allow a greater productivity for those value added | | | | mantra will become 'the right care, at the right time, |
| services. For this reason management science will be | | | | in the right place, using the right technology.' |
| as important as basic sciences in the healthcare of | | | | Lean thinking actually challenges healthcare |
| the future. So called 'implementation science' or | | | | administrators to develop systems that provide 'the |
| 'translational science' is little more than systematically | | | | right care, at the right time, in the right place using |
| applying management theory in the delivery of | | | | the right technology.' By applying Lean Thinking as |
| evidenced based practices. Currently it has been | | | | new services and buildings are considered all of this is |
| estimated that approximately 50% of a clinician's time | | | | possible today. The future is here. But it will take |
| is not necessary and not value added in the eyes of | | | | administrators and physician executives prepared to |
| the patient. If this waste is eliminated then clinician's | | | | think lean to fully capitalize on the changes. So you |
| will be able to spend more of their time caring for | | | | could say that Lean Thinking will be as important to |
| patients. This will reduce frustration for both clinician | | | | 'saving' healthcare as any advance in the biological |
| and patient. | | | | sciences might be. |
| Currently most facilities are organized around | | | | |